Provider Demographics
NPI:1003012642
Name:MAZLOOM, NARGES (DO)
Entity Type:Individual
Prefix:
First Name:NARGES
Middle Name:
Last Name:MAZLOOM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3445 HIGH POINT BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-7809
Mailing Address - Country:US
Mailing Address - Phone:610-866-5555
Mailing Address - Fax:610-866-3151
Practice Address - Street 1:3445 HIGH POINT BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7809
Practice Address - Country:US
Practice Address - Phone:610-866-5555
Practice Address - Fax:610-866-3151
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS016026207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology